Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants
<p>Abstract</p> <p>Background</p> <p>Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However,...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-01-01
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| Series: | BMC Psychiatry |
| Online Access: | http://www.biomedcentral.com/1471-244X/11/8 |
| _version_ | 1828844348842704896 |
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| author | Huibers Marcus JH Peeters Frenk PML de Jong Peter J Stant A Dennis Buskens Erik Ormel Johan de Jonge Peter van Rijsbergen Gerard D Elgersma Hermien J Bockting Claudi LH Arntz Arnoud Muris Peter Nolen Willem A Schene Aart H Hollon Steven D |
| author_facet | Huibers Marcus JH Peeters Frenk PML de Jong Peter J Stant A Dennis Buskens Erik Ormel Johan de Jonge Peter van Rijsbergen Gerard D Elgersma Hermien J Bockting Claudi LH Arntz Arnoud Muris Peter Nolen Willem A Schene Aart H Hollon Steven D |
| author_sort | Huibers Marcus JH |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.</p> <p>Methods/design</p> <p>Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.</p> <p>Discussion</p> <p>This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1907">NTR1907</a></p> |
| first_indexed | 2024-12-12T21:03:53Z |
| format | Article |
| id | doaj.art-47b4a124ab7b422eb433a599fb36e757 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-12T21:03:53Z |
| publishDate | 2011-01-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj.art-47b4a124ab7b422eb433a599fb36e7572022-12-22T00:12:04ZengBMCBMC Psychiatry1471-244X2011-01-01111810.1186/1471-244X-11-8Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressantsHuibers Marcus JHPeeters Frenk PMLde Jong Peter JStant A DennisBuskens ErikOrmel Johande Jonge Petervan Rijsbergen Gerard DElgersma Hermien JBockting Claudi LHArntz ArnoudMuris PeterNolen Willem ASchene Aart HHollon Steven D<p>Abstract</p> <p>Background</p> <p>Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.</p> <p>Methods/design</p> <p>Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.</p> <p>Discussion</p> <p>This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1907">NTR1907</a></p>http://www.biomedcentral.com/1471-244X/11/8 |
| spellingShingle | Huibers Marcus JH Peeters Frenk PML de Jong Peter J Stant A Dennis Buskens Erik Ormel Johan de Jonge Peter van Rijsbergen Gerard D Elgersma Hermien J Bockting Claudi LH Arntz Arnoud Muris Peter Nolen Willem A Schene Aart H Hollon Steven D Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants BMC Psychiatry |
| title | Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| title_full | Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| title_fullStr | Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| title_full_unstemmed | Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| title_short | Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| title_sort | disrupting the rhythm of depression design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants |
| url | http://www.biomedcentral.com/1471-244X/11/8 |
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